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醫(yī)學免費論文:新生兒呼吸機相關性肺炎危險因素分析
【摘要】 目的 通過分析新生兒重癥監(jiān)護病房呼吸機相關性肺炎的臨床特點，探討呼吸機相關性肺炎的危險因素。方法 對機械通氣超過48 h的134例新生兒臨床資料做回顧性分析，分析機械通氣持續(xù)時間、胎齡、出生體質(zhì)量、血漿蛋白水平、PaO2/FiO2、氧合指數(shù)、pH值與呼吸機相關性肺炎發(fā)生的相關性。結(jié)果 新生兒呼吸機相關性肺炎的發(fā)生率為40.30%，單因素分析機械通氣持續(xù)時間、胎齡、出生體質(zhì)量、血漿蛋白水平與呼吸機相關性肺炎的發(fā)生差異有顯著性(P<0.05);而PaO2/FiO2、氧合指數(shù)、pH值差異無統(tǒng)計學意義(P>0.05);多因素Logistic回歸分析機械通氣持續(xù)時間與呼吸機相關性肺炎的發(fā)生呈正相關(OR=3.149，95% CI=1.513～5.663，P<0.001)，而血漿白蛋白水平呈負相關(OR=0.795，95% CI=0.695～0.938，P<0.05)。結(jié)論 機械通氣持續(xù)時間、血漿白蛋白水平是新生兒呼吸機相關性肺炎發(fā)生的危險因素醫(yī).學全.在.線網(wǎng)站quanxiangyun.cn。
【關鍵詞】 機械通氣;肺炎;新生兒
An analysis of risk factors in neonatal ventilator-associated pneumonia
CHANG Ming，YANG Li，GU Shao-qing.Department of Pediatrics，The Affiliated Hospital of Jiangsu University，Zhenjiang 212001，China
[Abstract] Objective To analyse the clinical characteristics of ventilator-associated pneumonia in neonatal intensive care unit and to investigate the risk factors in neonatal ventilator-associated pneumonia.Methods An retrospective analysis of clinical data of 134 newborns with mechanical ventilation >48 hours was done.To investigate the correlation of the duration of mechanical ventilation，gestational ages，birth weights，the plasma protein levels，PaO2/FiO2，oxygenation index and pH values with neonatal ventilator-associated pneumonia.Results The incidence rate of neonatal ventilator-associated pneumonia was 40.30%.Univariate analysis showed that there were significantly difference for the duration of mechanical ventilation，gestational ages，birth weights，the plasma protein levels in neonatal ventilator-associated pneumonia and non-ventilator-associated pneumonia(P<0.05)，and there were no significantly difference for PaO2/FiO2，oxygenation index and pH values respectively(P>0.05).Multivariate stepwise logistic regression analysis showed that the duration of mechanical ventilation was positive correlation with neonatal ventilator-associated pneumonia(OR=3.149，95% CI=1.513～5.663，P<0.001)and the plasma albumin level was negative correlation with neonatal ventilator-associated pneumonia(OR=0.795，95% CI=0.695～0.938，P<0.05).Conclusion The duration of mechanical ventilation and the plasma albumin level were the risk factors in neonatal ventilator-associated pneumonia.
[Key words] mechanical ventilation;pneumonia;neonate
機械通氣(mechanical ventilation，MV)是治療呼吸衰竭的主要措施，隨著呼吸機在NICU的普及，新生兒搶救成功率大為提高，但其并發(fā)癥——呼吸機相關性肺炎(ventilator-associated pneumonia，VAP)也成為醫(yī)院內(nèi)主要的獲得性感染，VAP的預后直接關系到呼吸衰竭搶救成功與否�，F(xiàn)將2007年1月至2008年12月在NICU進行MV的新生兒臨床資料進行回顧性分析，探討VAP發(fā)生的危險因素，為針對性預防及治療提供臨床依據(jù)。
